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Medical device imaging data augmentation is a method of expanding existing datasets by generating new data samples,which is of great significance for improving the performance of artificial intelligence(AI)medical device-related models and clinical application effects.However,traditional data augmentation methods are usually limited by the quality,realism,and diversity of generated samples.Denoising diffusion probabilistic model(DDPM)is a generative model based on the noise diffusion process,and its main idea is to generate samples with high quality by modelling the sampling process of the target distribution as a process of progressive denoising from the noise distribution.The basic principles and working mechanisms of DDPM were reviewed,the application scenarios of this method in AI medical device data augmentation were analyzed,and its advantages,challenges,and future development directions were explored to provide a reference for the field of AI medical device data augmentation.
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Objective:To explore the feasibility and clinical effectiveness of preoperative positioning grid combined with CTA assisted design of anterolateral thigh perforator flap (ALTPF) in reconstruction of soft tissue defects around foot and ankle.Methods:From May 2018 to December 2021, a total of 18 cases with soft tissue defects around foot and ankle were admitted to the Department of Plastic and Reconstructive Surgery, First Affiliated Hospital of Ningbo University. The patients were 11 males and 7 females, aged from 32 to 78 years old, with an average age of 57.5 years old. Among them, 10 had chronic ulcer wounds, 6 had traumatic wounds, and 2 had postoperative wounds after malignant tumor resection. The sizes of soft tissue defect ranged from 6.0 cm×8.0 cm to 9.0 cm×13.0 cm, and the flap sizes ranged from 8.0 cm×10.0 cm to 11.0 cm×15.0 cm. Preoperative positioning grid combined with CTA three-dimensional reconstruction were used to mark the exit point of the perforator vessels in digital format, in order to restore the course of vessels and calculate the length of the vascular pedicles. ALTPFs were accurately designed based on the digitally reconstructed images, and then the ALTPFs were used to repair the soft tissue defects around the ankle. The flap donor sites were directly closed in stage Ⅰ. After the operation, all the patients were included in scheduled follow-ups at the outpatient department to observe the appearance of the recipient flaps and donor sites. The functional evaluation of the affected feet were assessed according to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score.Results:All 18 flaps survived, and the wounds in both the recipient and donor sites healed in stageⅠ. Postoperative follow-up for the 18 patients were 5 to 36 months, with an average of 13 months. At the last follow-up, the appearances of the flaps were good without swelling, the donor sites had good recovery, and there was no obvious scar hypertrophy. The function evaluation of the affected feet were found at excellent in 10 cases, good in 6 cases, and fair in 2 cases.Conclusion:Preoperative position grid combined with CTA three-dimensional reconstruction can digitally mark the exit points and running courses of the perforator vessels. It is an effective method for accurate position of perforator vessels before surgery. It can effectively reduce the operation time, lower the surgical risks, and achieve a high survival rate of the flap, thus holding considerable clinical value.
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Pulmonary fibrosis(PF)is a progressive,interstitial fibrotic lung disease characterized by persistent scar formation in the lung parenchyma,and a reduced quality of life and poor prognosis for patients.The pathogenesis of PF is unknown and there is a lack of effective therapeutic agents;however,animal models are currently the main tool used to explore the pathogenesis of the disease and to find effective therapeutic agents.PF can be induced by various factors and to different degrees according to known etiologies.Among these,bleomycin-induced models are widely used because of their reproducibility and the similarity between the fibrosis pathology and clinical conditions.The main induction method include intratracheal drip,intratracheal nebulization,tail vein injection,intraperitoneal injection,and transnasal inhalation,and these can be classified into single and multiple doses,according to the frequency of induction.Based on the relevant literature,the current review summarizes the characteristics of the bleomycin-induced PF model using different induction frequencies and method,to provide a basis for the application of this model.
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Objective:To investigate the clinical effect of myocutaneous flap combined with antibiotic-loaded polymethylmethacrylate (PMMA) cement in the treatment of Cierny-Mader type III-IV osteomyelitis.Methods:From April, 2014 to March, 2019, 53 patients with Cierny-Mader type III-IV chronic osteomyelitis were treated with myocutaneous flap combined with antibiotic-loaded PMMA cement. There were 33 males and 20 females, with an average age of (52.2±3.0) (29-78) years old. The area of the wound ranged from 2.0 cm×2.0 cm to 14.0 cm×28.0 cm. All flaps were closed directly. There were 23 patients who were removed the cement at 3 months after surgery, and the other 30 were not. After the surgery, the blood supply of the flap, the effusion of the wound, the complications of the donor area, signs of fresh bone destruction on X-ray and the color, the texture and scar of the flap were observed in the follow-up at the clinic.Results:Forty-nine cases healed in one stage, and 4 had delayed healing. Postoperative vascular crisis occurred in 6 cases and releasesd by prompt surgical exploration. The patients were followed-up for 0.6-3.0 years, with an average of 18 months. All 53 myocutaneous flaps completely survived ultimately. The color of flaps was similar to the recipient areas, and the flaps were smooth and soft and satisfactory in appearance. During the follow-up period, X-ray examination showed no sign of fresh bone destruction. Osteomyelitis was significantly controlled. There was no inflammation reaction such as swelling, pain, ulceration and effusion of the flaps, and there was no recurrence of osteomyelitis. All donor areas healed primarily.Conclusion:Myocutaneous flap combined with antibiotic-loaded PMMA cement has achieved good anti-infection effects in satisfactory results, less postoperative complications and low recurrence rate in the treatment of Cierny-Mader type III-IV osteomyelitis. Application and promotion of such technique would deliver good benefits.
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Objective To investigate the present situation of facial melanin of construction workers in Beijing area,to discuss the relative affecting factors,and to provide theoretical basis for theoretical research on photoaging and occupational protection for construction workers.Methods A total of 157 healthy male construction workers and 61 non-construction workers in Beijing were selected to conduct a questionnaire survey on their exposure to dust,sunlight,noise and high temperature in their working environment.The occurrence of melanin in their face skin was measured by melanin index (melanin index,MI) probe.T test,Spearman rank correlation analysis and multiple logistic regression were used for statistical analysis on two independent samples.Results The exposure of construction workers to dust,sunlight,noise and high temperature was significantly higher than that of non-construction workers (P ＜0.05);the melanin score of construction workers over 40 years old was significantly higher than that of non-construction workers (P ＜0.05) and positively correlated with age (P＜0.05);the melanin of construction workers was affected by age,sunlight and noise (P＜0.05).Conclusions The melanin level of the construction workers aged over 40 is significantly higher than that of the non-construction workers in Beijing.Age,sunlight and noise are the main factors affecting the melanin level.
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Microvascular manual suture technique is invented by doctor Carrel in 1912, it had become a core technique in microsurgery. This vascular anastomosis technique is effective. However, it also has some disadvantages such as time-consuming and labor- consuming. And as a residual foreign body, suture can also cause inflammation. In recent years, vascular couplers have been widely applied in clinic, this method ensuring the quality of anastomosis with faster speed. The four principles on ideal vascular anastomosis, which put forward by Carrel, is the target of improvement on vascular anastomosis tools. In recent years, Ring-coupling using negative pressure, vascular stents, hook stapling anastomat, fibrin glue, P407 and other new technologies have been reported, this paper will focus on the advantages and disadvantages of these technologies.
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Objective@#To investigate the effect of O-Z flap for the reconstruction of round-or elliptical-shaped defects following the scalp tumor removal.@*Methods@#The resection of the scalp tumor resulted in a round or elliptical-shaped defect. Intraoperative frozen section identified pathological diagnosis, while also ensured margin being tumor-free. Based on the size and location of the defect, the mobility of the surrounding scalp and hair distribution, two local flaps were designed in opposite directions on each side of the defect. The two flaps were rotated to close the defect in an O-Z fashion.@*Results@#From April 2016 to November 2017, 6 patients underwent defect reconstruction using the scalp O-Z flap. The etiologies included basal cell carcinoma (n=2), squamous cell carcinoma (n=2), and trichilemoma and epidermoid cyst (n=2). The defect size ranged from 3.0cm×3.5cm to 5.0cm×6.0cm. Necrosis on the distal of the flap had occurred in 1 patient. It was taken approximately 6% of the flap size, and healed after conservative management. Other flaps survived without any complications. After 3 to 12 months follow-up, the appearance of the sclap was satisfactory and tumor recurrence was not noticed.@*Conclusions@#The O-Z flap technique can be considered as an alternative for the medium-sized defect reconstruction of the scalp. The postoperative outcome of scalp was satisfactory, without disrupted hair orientation.
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Objective To observe the treatment outcome of using reversed island flap based on cutaneous branch of dorsal metacarpal artery for middle-and-distal finger soft tissue defect.Methods From May,2015 to March,2017,21 cases of middle-and-distal finger soft tissue defect were treated with reversed island flaps based on cutaneous branch of dorsal metacarpal artery which were designed on the dorsal hand pedicled by dorsal metacarpal artery.The flap was then elevated and rotated at the point where digital common artery was anastomosed with the terminal branch of the dorsal metacarpal artery.The cutaneous nerve included in the flap was anastomosed with the terminal branch of digital nerve to restore sensation and the donor site was covered directly.Regular followed-up was performed after operation.Results Except 1 case was suffered with distal 1/3 skin flap necrosis,flaps were well developed.Postoperative follow-up period was 3 to 12 months.All these flaps recovered with satisfying appearance and quality,excellent sensation with grade S3 to S4 and 5 to 8 mm of two-point discrimination.Range of motion(ROM)of the metacarpalphangeal and interphalangeal joint of the injured fingers was good.The excellent and good rate was 95.2％.Conclusion Reversed island flap based on dorsal cutaneous branch of dorsal metacarpal artery transfer is an ideal method for repairing middle-and-distal finger soft tissue defect.The surgery is simple.Reliable blood supply and sensation can be achieved without sacrificing the primary artery and nerve.There is minor donor site damage and very few complications.
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BACKGROUND:With the continuous development of nanotechnology, a growing number of nanotechnologies have been used in the field of biological medicine, providing a great deal of interest for the diagnosis and treatment of disease. OBJECTIVE:To review the research situation of nanobiomaterials and its application in biological medicine. METHODS: The articles about nanobiomaterials and nano bioceramic materials were retrieved from Chinese Journal Ful-text Database, PubMed and Wanfang database published during January 2000 to October 2014 by the first author using computer. Key words were “nano, bioceramics” in Chinese and English, respectively. RESULTS AND CONCLUSION: With the development of nanotechnology, some nanotechnologies have entered the stage of practical application. Application of nanotechnology plays a preventive effect to the occurrence and development of disease. Nano-ceramic significantly increases the strength, toughness and superplasticity of materials, overcomes many deficiencies of biological ceramics, and has been widely used in the field of orthopedics, such as artificial joints, artificial bones, bone filing material, bone replacement materials, artificial vertebrae and so on.
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Objective To investigate the clinical characteristics and surgical treatment of primary bone non-Hodgkin′s lymphoma.Methods Recalling a case of primary bone non -Hodgkin′s lymphoma patient data in Affiliated Maojian Hospital of Hubei University of Medicine .This patient was hospitalized because of pain in the right upper arm.By improving the relevant examination and diagnosis of right humeral bone tumors ,We had successfully completed a bone tumor resection and graft as well as dual plate fixation .Results Pathological diag-nosis after surgery showed the primary non -Hodgkin′s lymphoma of bone ,9 months follow-up after surgery ,the treatment effecincy was good .There were no tumor recurrence and distant metastasis .Conclusion Primary non-Hodgkin′s lymphoma of bone is uncommon in clinical practice .If there is primary bone tumor with no obvious sys-temic symptoms in elderly patients , we should considered it as a possible diagnosis of primary bone non -Hodgkin′s lymphoma,in order to reduce the possibility of misdiagnosis and mistreatment .Short-term effects of surgical treatment of this disease is excellent .
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Objective To analyze therapeutic effects of different methods of treating tibial plateau fractures. Methods The curative effects of the 35 operative cases and 32 non operative cases were evaluated according to the score scale of knee injures. The data were analyzed statistically. Results The excellent and good rate of functional restoration was 91.4% in the operative group and 62.5% in the non operative group (P
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Objective To explore the role of a new apoptosis related gene TFAR 19 in the pathogenesis of systemic lupus erythematosus (SLE) and the relationship between TFAR 19 and SLE.Methods ELISA was used to test if there is relation between TFAR 19 and SLE.Results It was found that in active SLE patients there was higher titer of TFAR 19 antibody than that in stability patients and normal controls.No significant difference was seen between stability patients and normal controls.Conclusion It is first put forward that TFAR 19 may be related with SLE pathogenesis and disease activity.
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AIM: To investigate the effects of oxysterols on matrix metalloproteinase (MMP) and tissue inhibitor of metalloproteinase-1 (TIMP-1) expression in vascular smooth muscle cells. METHODS: Rabbit aortic vascular smooth muscle cells were cultured in vitro and incubated with cholesterol, Triol and 25-hydroxycholesterol (25-OH), respectively. Slot blot was used to detect the mRNA expression level of TIMP-1 in vascular smooth muscle cells (VSMCs); meanwhile the protein expression level of MMP-9 and TIMP-1 was detected by immunohistology. RESULTS: Triol and 25-OH inhibited the expression of TIMP-1 compared with control and cholesterol, but have no effect on expression of MMP-9. CONCLUSION: Both Triol and 25-OH downregulated TIMP-1 expression in VSMCs .
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AIM: To investigate the apoptosis of endothelial cells (EC) induced by oxysterols and to examine the effect of amlodipine on the apoptosis induced by oxysterols.METHODS: Light microscope, electron microscope, DNA agarose gel electrophoresis and flow cytometry were used to detect the apoptosis of EC.RESULTS: The characteristic morphological features of apoptosis were observed under light and electron microscope; DNA electrophoresis showed"DNA Ladder"; Flow cytometry showed the sub-G1 peak, apoptotic rate is 32.25% and 23.04% in Triol-treated and 25-OH-treated groups, respectively. While treated EC with amlodipine at the same time, the apoptotic rate decreased significantly. CONCLUSION: Both Triol and 25-OH can induce apoptosis of EC, which can be inhibited by amlodipine.
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AIM: To clarify the role of new apoptosis-related gene, TF-1 cell apoptosis-related gene 19(TFAR19), in the pathogenesis of systemic lupus erythematosis (SLE) and the relationship between TFAR19 and SLE. METHODS: DNA Ladder detection, Western blotting, immunological fluorescence method, ELISA and so on were used to test if ultraviolet B(UVB) could induce HaCaT cell apoptosis and TFAR19 expression. RESULTS: HaCaT cell apoptosis could be detected after 24 hours of 30 mj/cm 2 UVB irradiation. Also, we found that in active SLE patients, the TFAR19 antibody was increased, but not significant compared to the normal control. CONCLUSION: TFAR 19 is involved in the process of UVB induced ketatinocyte line HaCaT apoptosis and SLE pathogenesis.